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Wellness

“Wellness,”
intoned Dan Rather in November 1979, introducing a “60 Minutes” segment on a new health movement known by that name. “There’s a word you don’t hear every day.”

More than three decades later, wellness is, in fact, a word that Americans might hear every day, or close to it. You can sign up for your company’s employee-wellness program, relax in a wellness spa treatment or even plan some “wellness tourism” for your next vacation. Your cat or dog can get in on the action, too, since the W-word has been pressed into service as a brand of all-natural pet food.

Wellness is here to stay, despite misgivings over the years that it isn’t such a well-formed word. How did it take over, and whatever happened to good old health?

Though the Oxford English Dictionary traces wellness (meaning the opposite of illness) to the 1650s, the story of the wellness movement really begins in the 1950s. New approaches to healthful living were emerging then, inspired in part by the preamble to the World Health Organization’s 1948 constitution: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Halbert L. Dunn, chief of the National Office of Vital Statistics, was looking for new terminology to convey the positive aspects of health that people could achieve, beyond simply avoiding sickness. In a series of papers and lectures in the late ’50s, Dunn sketched out his concept of “high-level wellness,” defined as “an integrated method of functioning, which is oriented toward maximizing the potential of which the individual is capable.”

Dunn collected his presentations in a 1961 book, “High-Level Wellness,” but it would take another decade for his work to resonate with a committed group of followers. An early acolyte was John W. Travis, who picked up Dunn’s book in 1972 from a $2 clearance table at the bookstore of Johns Hopkins Medical School, where he was enrolled in a preventive-medicine residency program. Travis didn’t think much of Dunn’s buzzword at first. “I thought the word wellness was stupid, and it would never catch on,” he recently told me. But Travis was enamored with the way Dunn presented his ideas, and he put those ideas into action — and reluctantly embraced the word itself — when he opened the Wellness Resource Center in Mill Valley, Calif., in November 1975. The center promoted self-directed approaches to well-being as an alternative to the traditional illness-oriented care of physicians.

Wellness was so unfamiliar at the time, Travis recalls, that he constantly had to spell the word when using it over the phone. It soon got national attention when a young doctoral student named Donald B. Ardell profiled Travis’s center in the April 1976 issue of Prevention magazine. In a sidebar, Prevention’s editor, Robert Rodale, welcomed the “exciting field of wellness enhancement,” promising that the magazine would “examine all aspects of wellness promotion.” Even greater exposure came with Rather’s “60 Minutes” piece, which focused on Travis and the Mill Valley center.

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Travis and Ardell found a kindred spirit in Bill Hettler, a staff physician at the University of Wisconsin-Stevens Point. Influenced by their work, Hettler founded the annual National Wellness Conference at Stevens Point, now in its 35th year. The conference lent valuable academic prestige to the wellness movement. It also caught the attention of Tom Dickey, who was working with the New York publisher Rodney Friedman in the early 1980s to set up a monthly newsletter on health, based at the University of California, Berkeley. Friedman wanted the publication to compete with the Harvard Medical School Health Letter, and Dickey suggested using wellness in the title as a contrast. In 1984, the Berkeley Wellness Letter was born.

Joyce Lashof, then the dean of Berkeley’s School of Public Health, remembers that wellness was initially a tough sell at the school. Not much was known on campus about the earlier work of Travis and his fellow wellness advocates, but Lashof’s colleagues associated the term wellness with the “flakiness” of Mill Valley and surrounding Marin County. The NBC newsman Edwin Newman had televised an exposé of Marin County’s hedonistic lifestyle, which notoriously opened with a woman getting a peacock-feather massage from two nude men. The Berkeley Wellness Letter, however, managed to avoid such unseemly associations by publishing serious, evidence-based articles on health promotion, while debunking many of the holistic health fads of the day.

Though the Berkeley newsletter, which at its peak reached a million subscribers, did much to establish the credibility of wellness in the ’80s, language pundits continued to raise their eyebrows. Newman, who also moonlighted as a usage commentator, belittled wellness, calling it an example of “bloating” in the language. In 1988, a survey of the Usage Panel for the American Heritage Dictionary of the English Language found that a whopping 68 percent of panelists disapproved of the word when used to refer to employee-wellness programs and the like, and a critical note was included in the dictionary’s 1992 edition.

But carping over wellness faded away in the ’90s as the term gained a foothold in everyday use. The American Heritage Dictionary silently dropped the usage note on wellness in its fourth edition in 2000, a decision that its supervising editor, Steve Kleinedler, chalks up to the growing prevalence of wellness programs in the workplace and beyond. A word that once sounded strange and unnecessary, even to its original boosters, has become tacitly accepted as part of our lexicon of health. Well, well, well.

Reader Question Erskine Kelly asks: "What is the difference between preventive and preventative? Like use versus utilize, my ears turn off when I hear the use of utilize or preventative by some so-called expert."

There is, in fact, no difference in meaning between preventive and preventative. Some, including William Safire in a 1993 On Language column, have suggested using preventive as an adjective and preventative as a noun, but both forms of the word have alternated freely as adjective and noun since they entered the language in the 17th century. Despite their introduction into English at roughly the same time (the Oxford English Dictionary dates preventive back to 1626 and preventative to 1655), preventive has won out as the preferred version.

Many usage guides have disparaged preventative as improper, because it doesn't accord with classical roots: the Latin past participle stem praevent- adds -ion to form prevention and -ive to form preventive. Words ending in -ative ought to have the -at- in the root already: demonstrat- begets demonstration and demonstrative, narrat- begets narration and narrative, and so forth. Since we don't have preventation, then preventative is equally misbegotten, by this way of thinking.

English word formation isn't always that tidy, however. The -ative ending often shows up even when there isn't a corresponding noun ending in -ation: we have authoritative without authoritation,qualitative without qualitation and talkative without talkation. Talk, of course, isn't even from Latin, but the friendly -ative suffix clung to it anyway, by analogy with other verbs that form adjectives by appending -ative, like affirm and affirmative, or represent and representative. Preventative got created from prevent by this same analogical pattern.

Complaints about preventative go back to the late 18th century. The spelling reformer James Elphinston wrote in 1787 that preventative could be heard among Londoners in unguarded speech, along with other disapproved pronunciations like umberella and mischievious that sneak in an extra syllable (a process that linguists call "epenthesis"). A 1795 review of the Earl of Lauderdale's "Letters to the Peers of Scotland" criticized the appearance of preventative in the text, declaring that it was "not English." Similarly, Francis Barnett took Andrew Reed's "No Fiction" to task in 1823 for including the word: "In the English language there is no such word as preventative, preventive there is."

Preventative soon drew enough attention that The New York Mirror devoted a whole column to it in the newspaper's March 6, 1824, edition. "The conversion of preventive into preventative is an error too common," wrote the anonymous scribe. "Some fall into it from ignorance, and others from inadvertence." The writer attributed its use to "a disposition in people to spell words with more letters than belong to them; or to insert a syllable or syllables, where addition, so far from being advisable or requisite, proves injurious." The column concluded with a call to action: "Let those, then, who from carelessness or any other cause, have been in the habit of using preventative, make it henceforth an invariable rule, whether in writing or in utterance, to prefer the proper and unexceptionable term preventive."

That call went unheeded, however, as preventative has managed to survive as a variant, albeit a much less popular one. A search on the Corpus of Contemporary American English finds preventive beating preventative by a ratio of about 6 to 1 in current written usage, across both academic and nonacademic texts. You can still get away with using preventative in standard English, but that extraneous syllable won't gain you anything, other than disdain from the sticklers.